Xin-Min Liu

Twelve Months Clinical Outcome of Drug‐Eluting Stents Implantation or Coronary Artery Bypass Surgery for the Treatment of Diabetic Patients with Multivessel Disease

Studies comparing coronary artery bypass grafting (CABG) with drug‐eluting stent (DES) for the treatment of diabetic patients with multivessel disease are relatively scarce although controversies exist concerning the relative efficacy of CABG versus DES.

Relationship between red blood cell distribution width and intermediate-term mortality in elderly patients after percutaneous coronary intervention

Background Large-scale clinical research on the relationship between red blood cell distribution width (RDW) and intermediate-term prognosis in elderly patients with coronary artery disease (CAD) is lacking. Thus, this study investigated the effects of RDW on the intermediate-term mortality of elderly patients who underwent elective percutaneous coronary intervention (PCI). Methods Data from 1891 patients ≥ 65 years old underwent elective PCI from July 2009 to September 2011 were collected. Based on preoperative median RDW (12.3%), the patients were divided into two groups. The low RDW group (RDW < 12.3%) had 899 cases; the high RDW group (RDW ≥ 12.3%) had 992 cases. The all-cause mortality rates of the two groups were compared. Results Patients in the high RDW group were more likely to be female and accompanied with diabetes, had lower hemoglobin level. The mean follow-up period was 527 days. During follow-up, 61 patients died (3.2%). The postoperative mortality of the high RDW group was significantly higher than that of the low RDW group (4.3% vs. 2.0%, P = 0.004). After adjusting other factors, multivariate Cox regression analysis revealed that preoperative high RDW was significantly associated with postoperative all-cause mortality (hazard ratio: 2.301, 95% confidence interval: 1.106–4.785, P = 0.026). Conclusions Increased RDW was an independent predictor of the increased intermediate-term all-cause mortality in elderly CAD patients after elective PCI.

Anatomic properties of coronary arteries are correlated to the corrected thrombolysis in myocardial infarction frame count in the coronary slow flow phenomenon.

BackgroundCoronary slow flow phenomenon (CSFP) is an important, angiographic clinical entity, but its etiology remains unclear. The purpose of this study was to explore the potential role of local coronary anatomic properties in the genesis of CSFP. MethodsOne hundred and thirty-one consecutive patients with CSFP and 131 patients with angiographically normal coronary flow were prospectively enrolled after documenting coronary flow by corrected thrombolysis in myocardial infarction frame count (CTFC). Local anatomic parameters including the tortuosity index (TI), the ostial-to-middle diameter ratio, the ostial-to-middle cross-sectional area ratio, and the number of distal branches (NDB) of arteries at end-systole were compared between patients with CSFP and controls. ResultsFor each major coronary artery, CSFP patients had higher TI and NBD compared with controls (all P<0.05). The diameter ratio and cross-sectional area ratio of the three major coronary arteries were higher in the CSFP group (P=0.004 and 0.020, respectively). The TI (r=0.476, P<0.001) and NDB (r=0.186, P=0.004) were significantly correlated with CTFC. However, the higher TI (&bgr;=0.424, P<0.001) was the only independent correlate to CTFC. Multivariate logistic analysis revealed that TI (adjusted odds ratio 1.17, 95% confidence interval 1.11–1.23, P<0.001) and NDB (adjusted odds ratio 2.20, 95% confidence interval 1.50–3.21, P<0.001) were independent predictors of CSFP. ConclusionThe presence of CSFP was associated with higher tortuosity and more distal branches in coronary arteries, indicating that the anatomic properties of coronary arteries could also play a role in the pathogenesis of CSFP.

Angiographic evaluation of a new technique for common femoral artery access: The inguinal ligament-guided approach

☆ This study was partly supported by grants from the dation of China (nos. 81070166 and 81270284) and th Program of Beijing Municipal Commission of Education ( ⁎ Corresponding author at: Department of Cardiology, B Medical University, Beijing Institute of Heart, Lung, andBloo Road, Chaoyang District, Beijing 100029, China. Tel.: + 64456078. E-mail address: chshma@vip.sina.com (C.-S. Ma). 1 These authors take responsibility for all aspects of th bias of the data presented and their discussed interpret

Chronic heart failure in patients with nonalcoholic fatty liver disease: prevalence, clinical features, and relevance

Objective This study was performed to assess the prevalence of nonalcoholic fatty liver (NAFL) in patients with symptomatic congestive heart failure (CHF) and compare the clinical features with those of patients without NAFL. Methods In total, 102 patients with CHF were divided into NAFL and non-NAFL groups according to their hepatic ultrasonography findings. All patients underwent transthoracic echocardiography and cardiac magnetic resonance examination. Follow-up was performed for major cardiovascular events (MACE) and readmission due to heart failure at 1, 3, 6, and 12 months after the index hospitalization. Results NAFL was detected in 37 of 102 patients (36.27%). Compared with the non-NAFL group, patients with NAFL were younger, had a higher body mass index and left ventricular (LV) mass index, and had more severe fibrosis. MACE and readmission occurred in 15 patients in the NAFL group and 29 patients in the non-NAFL group, without a significant difference. Linear regression analysis revealed that after adjusting for confounders, NAFL was independently associated with the LV fibrosis size and the ratio of the LV fibrosis size to the LV mass index. Conclusions NAFL is present in more than one-third of patients with CHF and is associated with the severity of LV fibrosis.

Extracellular volume quantitation using dual-energy CT in patients with heart failure: Comparison with 3T cardiac MR

BACKGROUNDS Cardiac magnetic resonance (CMR) T1 mapping and the extracellular volume (ECV) have been developed to quantitative analysis of diffusely abnormal myocardial fibrosis (MF). However, dual-energy CT (DECT) has a potential for calculation of ECV. The aim of this study is to evaluate the feasibility and accuracy of DECT technique in determining the ECV in patients with heart failure, with 3T CMR as the reference. METHODS Thirty-five patients with various reasons of heart failure were enrolled in this study. Both DECT and CMR exams were completed within 24 h. ECVs were calculated, and the relationship between DECT-ECV, CMR-ECV, and other heart function parameters, including left ventricular end systolic and diastolic volume, cardiac output and ejection fraction (LVESV, LVEDV, CO, LVEF), Brain natriuretic peptide (BNP) was determined. All participants gave informed consent, and the study was approved by the institutional review board. RESULTS The median ECVs on DECT and CMR were 33% (95%CI: 32%-36%) and 30% (95%CI: 30% - 32%), respectively. A good correlation between myocardial ECV at DECT and that at CMR (r = 0.945, P < 0.001) was observed. Bland-Altman analysis between DECT and CMR showed a small bias (2.6%), with 95% limits of agreement of -0.4% and 5.6%. Interobserver agreement for ECV at DECT was excellent (ICC = 0.907). Both ECVs, for DECT and CMR, were inversely associated with LVEF and CO. CONCLUSION DECT-based ECV could be an alternative non-invasive imaging tool for myocardial tissue characterization. However, overestimation of the extent of diffuse MF is observed with use of DECT.

SHORT- AND LONG-TERM OUTCOMES OF CORONARY REVASCULARISATION IN PATIENTS WITH SEVERE LEFT VENTRICULAR DILATATION

Objectives Patients with coronary artery disease accompanied by severe left ventricular dilatation (LVD) are at higher risk for heart failure and death. However, their clinical and angiographic profiles, short- and long-term outcomes after revascularisation are unknown. Methods A total of 4283 patients (median age 60.0 years; 77.4% male) undergoing coronary revascularisation in our centre from July 2003 to September 2005 were stratified according to end-diastolic dimension (EDD). Patients with severe LVD (EDD>70 mm), mild/moderate LVD (EDD 52.7 mm to 70.0 mm in males, EDD 48.3 mm to 70.0 mm in females), and no LVD (EDD<52.7 mm in males, EDD<48.3 mm in females) was compared for outcome analysis. Results Patients with severe LVD had more complex lesions (eg, chronic total occlusions, multi-vessel disease) with more prior myocardial infarction, valvular impairments and renal dysfunction (all p<0.001). Patients successfully discharged were followed up for a median of 548 (455–669) days. Severe LVD was significantly associated with increased in-hospital mortality (5.4% vs 1.6% vs 1.0%, p<0.001) and composite ischaemia (6.9% vs 2.5% vs 2.1%, p<0.001) compared with mild/moderate LVD and no LVD groups. By multivariable analysis, severe LVD was a significant independent predictor of in-hospital (HR 1.858, 95% CI 1.323 to 2.611, p<0.001) and follow-up mortality (HR 1.697, 95% CI 1.253 to 2.298, p=0.001) after revascularisation. Conclusions Patients with severe LVD have more co-morbidities and complex coronary lesions. Severe LVD in patients undergoing coronary revascularisation was an independent predictor of early and late mortality and adverse ischaemic outcomes.